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Introdução: A saúde no Brasil se estabeleceu como direito universal a partir da promulgação da Constituição da República Federativa do Brasil em 1988, o qual foi posteriormente ratificado e normatizado pela edição da Lei no 8080 de 1990, que dispõe sobre as condições para a promoção, proteção e recuperação da saúde, a organização e o funcionamento dos serviços correspondentes, conhecida por Lei Orgânica do Sistema Único de Saúde (SUS). Tendo como base os princípios norteadores foi lançado, pelo Ministério da Saúde, o Programa de Saúde da Família, em 1994, o qual se tornou Estratégia Saúde da Família, 12 anos após. No momento em que o país começou priorizar a Atenção Primária à Saúde (APS) como eixo central do sistema de saúde, assim como ocorre nos principais sistemas nacionais de saúde no mundo, percebeu-se a escassez de profissionais médicos formados para atuação nesse nível de atenção. Emergiu, então, a necessidade de ampliar o acesso à residência em Medicina de Família e Comunidade (MFC) no Brasil. Objetivo: Apresentar aspectos da constituição histórica dos Programas de Residência em MFC (PRMFC) brasileiros. Resultados: Nos primeiros anos do século XX, em diversas unidades federativas, houve considerável aumento de vagas de RMFC com destaque para o PRMFC da Secretaria Municipal de Saúde do Rio de Janeiro , abrangendo cidades que antes não contavam com essa formação. Tal contexto pode ser compreendido à luz da significativa articulação construída no âmbito do SUS, para a formação de recursos humanos em saúde. Conclusão: A Residência em MFC mantém-se em expansão no país e já pode ser encontrada em algumas das principais cidades do Brasil.
Introduction: Health in Brazil was established as a universal right from the promulgation of the Constitution of the Federative Republic of Brazil in 1988. Subsequently, ratified and standardized by the edition of the Law 8080 of 1990, which provides the conditions for the promotion, protection and recovery of health, organization and functioning of the corresponding services, known as the organic law of the unique system of Health (SUS). Based on the guiding principles of SUS, the Family Health Program was launched by the Ministry of Health in 1994, which became the Family Health Strategy twelve years later. As the country began to prioritize Primary Health Care (PHC) as the central axis of the health system, as in the main national health systems in the world, the shortage of medical professionals trained to this level of care. The need to expand access to family and community medicine (MFC) in Brazil emerged. Objective: To present aspects of the historical constitution of the Residency Programs in Brazilian CFM (PRMFC). Results: In the first years of the 20th century, in several federal units, there was a considerable increase in RMFC vacancies with emphasis on the PRMFC of the Municipal Health Department of Rio de Janeiro , covering cities that did not previously have this training. This context can be understood in the light of the significant articulation built within the SUS, for the formation of human resources in health. Conclusion: The MFC Residency continues to expand in the country and can already be found in some of the main Brazilian cities.
Introducción: La salud en Brasil se estableció como derecho universal a partir de la Constitución Federal de 1988, y fue posteriormente, ratificado y normalizado por la edición de la Ley no. 8080 de 1990, que dispone sobre las condiciones para la promoción, protección y la recuperación de la salud, la organización y el funcionamiento de los servicios correspondientes, conocida como Ley Orgánica del Sistema Único de Salud (SUS). Con base en los principios orientadores del SUS, fue lanzado por el Ministerio de Salud, el Programa de Salud de la Familia, en 1994, el cual se convirtió en Estrategia Salud de la Familia, doce años después. En el momento en que el país comenzó a priorizar la Atención Primaria de Salud (APS) como eje central del sistema de salud, así como ocurre en los principales sistemas nacionales de salud en el mundo, se percibió la escasez de profesionales médicos formados para actuación en ese nivel de salud atención. Se planteó la necesidad de ampliar el acceso a la residencia en Medicina de Familia y Comunidad (MFC) en Brasil. Objetivo: Presentar aspectos de la constitución histórica de los Programas de Residencia en MFC (PRMFC) brasileños. Resultados: En los primeros años del siglo XX, en diversas unidades federativas, hubo un considerable aumento de vacantes de RMFC con destaque para el PRMFC de la Secretaría Municipal de Salud de Rio de Janeiro , abarcando ciudades que antes no contaban con esa formación. Tal contexto puede ser comprendido por la significativa articulación construida en el ámbito del SUS, para la formación de recursos humanos en salud. Conclusión: La Residencia en MFC se mantiene en expansión en el país y ya puede ser encontrada en algunas de las principales ciudades de Brasil.
Asunto(s)
Atención Primaria de Salud , Medicina Familiar y Comunitaria , Médicos Generales , Internado y ResidenciaRESUMEN
Objective To explore the application method and value of mind mapping in the clinical teaching of general practitioners for the purpose of improving the teaching qualities. Methods A total of 60 GPs were divided into the test group and control group, undergoing the mind mapping teaching and tra-ditional teaching, respectively. The clinical knowledge achievements were compared in the two groups, and the results were analyzed. At the same time, a questionnaire was conducted. Results The difference between two groups in theoretical teaching was statistically significant (P<0.05), and there was no significant difference in physical examination (P>0.05). In addition, the results of the questionnaire survey showed that the test group was better than the control group in medical knowledge, self-learning ability, interpersonal communication ability, team cooperation ability and other dimensions. Conclusion Mind mapping is an effective teaching tool for general practitioners.
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Objective To evaluate the effectiveness of mini clinical evaluation exercise (miniCEX) in community rotation of general practice residency training.Methods Forty nine general practice residency trainees,who participated in community rotation during July 2012 to July 2014 in 3 community teaching bases,were randomly divided into two groups:25 trainees in intervention group received conventional teaching and additional 2 rounds of mini-CEX in one month,and 24 trainees received conventional teaching only.The changes of self-evaluation scores of clinical competence after the community rotation were evaluated.Focus group discussions of 8 trainees and 8 teachers from intervention group were also adopted in January to February 2013 to assess the effectiveness of mini-CEX.Results Three trainees withdrew in the study and the interventional group completed 232 mini-CEXs.The self-evaluation scores of clinical competence were elevated in all items in interventional group after community rotation (from 7.03 ± 0.68 to 7.30 ±0.77 in medical history,from 7.00 ± 0.83 to 7.18 ± 0.88 in physical examination,from 7.42 ± 1.20 to 7.52 ± 0.76 in humanistic qualities,from 6.79 ± 0.82 to 7.12 ± 0.70 in clinical judgment,from 6.85 ± 1.06 to 7.18 ± 0.81 in counseling skills,from 6.85 ± 1.15 to 7.12 ± 0.96 in organization,from 7.09 ±0.81 to 7.33 ±0.69 in overall competence),while in control group,scores of humanistic qualities (from 7.74 ± 0.89 to 7.60 ± 0.97),clinical judgment (from 6.94 ± 0.77 to 6.77 ± 1.10) and organization/efficiency (from 6.94 ± 0.96 to 6.80 ± 0.76) were declined.Mter adjusting self-evaluation score before rotation,the increased scores in clinical judgment(7.12 ±0.70 vs.6.77 ± 1.10,F =4.339,P =0.042) and organization (7.12 ± 0.96 vs.6.80 ± 0.76,F =4.336,P =0.042) of intervention group were significantly higher than those of control group.In focus group discussions both trainees and teachers recognized that mini-CEX would enhance clinical competence,be more comprehensive in assessing and adaptable in training program than former rotation tests.The major concerns of using mini-CEX were subjective rating process,non-unified rating standards and insufficient teaching ability.Conclusions Application of mini-CEX in community rotation of general practice residency training can enhance clinical competency of trainees.